Address and Name Change Forms

Please print the form below, complete and return to:
Fax: 704-233-8125 (No cover sheet required)

Mail:
Registrar
Wingate University
Campus Box 3031
Wingate, NC 28174

ADDRESS CHANGE


NAME:  _______________________________________________________________
 
SOCIAL SECURITY #:  ___________________________________________________

STUDENT ID #:  ________________________________________________________
 
 
Old Address:  __________________________________________________________
 
                         ___________________________________________________________ 
 
 
New Address:  __________________________________________________________
 
                          ___________________________________________________________
 
County:  _______________________________  Phone #:  ________________________
 
 
Signature:  _________________________________________ Date:  _______________ 
 
 
NAME CHANGE  
 
(Requires Social Security Card, Passport or Marriage License)
 
 
Old Name:  _______________________________________________________________
 
New Name:  ______________________________________________________________
 
Signature:  _________________________________________ Date:  _________________